Stroke:β受体阻滞剂或他汀类药物使用与海绵状畸形出血风险之间的关系

2022-04-13 MedSci原创 MedSci原创

使用β受体阻滞剂(而非他汀类药物)可降低CCM患者颅内出血或持续性/进行性局灶性神经功能缺损的风险。

脑海绵样畸形(CCMs)可表现为癫痫发作、颅内出血、局灶性神经功能缺损,也可在脑磁共振成像检查中偶然发现。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在明确β受体阻滞剂或他汀类药物的使用与未来有症状的颅内出血或颅内海绵状畸形(CCM)造成的持续性/进行性局灶性神经功能缺损的风险之间的关系。

基于人群的苏格兰颅内血管畸形成年队列前瞻性地确定了在1999年-2003年或2006年至2010年首次诊断为CCM的苏格兰成年居民。在长达15年的前瞻性随访中,研究人员比较了使用β受体阻滞剂或他汀类药物与新发颅内出血或持续/进行性CCM所致的局灶性神经功能缺损发生之间的关系。研究人员确认了比例风险,并采用多变量调整的生存分析,包括年龄、CCM就诊时的颅内出血和脑干CCM位置。

300名成年人中有63人(21%)使用了β受体阻滞剂(27/63[43%]使用了心得安),73人(24%)在3634人次/年的随访中使用了他汀类药物。基线时,在预先指定的潜在混杂因素中,唯一具有统计学意义的不平衡是使用他汀类药物引起的年龄和使用-受体阻滞剂引起的颅内出血。研究人员发现使用β受体阻滞剂与较低的新发颅内出血或持续/进展性局灶性神经功能缺损风险相关(校正风险比为0.09 [95%CI为0.01-0.66];P=0.018)。他汀类药物的使用与颅内出血或持续/进展性局灶性神经功能缺损的风险降低无关(校正风险比为0.37 [95%CI为0.01-1.07];P=0.067)。

由此可见,使用β受体阻滞剂(而非他汀类药物)可降低CCM患者颅内出血或持续性/进行性局灶性神经功能缺损的风险。

 

原始出处:

Susanna M. Zuurbier.et al.Association Between Beta-Blocker or Statin Drug Use and the Risk of Hemorrhage From Cerebral Cavernous Malformations.stroke.2022.https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.037009.

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    2022-04-28 zhyy88
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    2022-04-14 wushaoling
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    2022-04-14 cooco

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